担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Face recognition is impaired in patients with prosopagnosia, which may occur as a side effect of neurosurgical procedures. Face selective regions on the ventral temporal cortex have been localized with electrical cortical stimulation (ECS), electrocorticography (ECoG), and functional magnetic resonance imagining (fMRI). This is the first group study using within-patient comparisons to validate face selective regions mapping, utilizing the aforementioned modalities. Five patients underwent surgical treatment of intractable epilepsy and joined the study. Subdural grid electrodes were implanted on their ventral temporal cortices to localize seizure foci and face selective regions as part of the functional mapping protocol. Face selective regions were identified in all patients with fMRI, four patients with ECoG, and two patients with ECS. From 177 tested electrode locations in the region of interest (ROI), which is defined by the fusiform gyrus and the inferior temporal gyrus, 54 face locations were identified by at least one modality in all patients. fMRI mapping showed the highest detection rate, revealing 70.4% for face selective locations, whereas ECoG and ECS identified 64.8 and 31.5%, respectively. Thus, 28 face locations were co-localized by at least two modalities, with detection rates of 89.3% for fMRI, 85.7% for ECoG and 53.6 % for ECS. All five patients had no face recognition deficits after surgery, even though five of the face selective locations, one obtained by ECoG and the other four by fMRI, were within 10 mm to the resected volumes. Moreover, fMRI included a quite large volume artifact on the ventral temporal cortex in the ROI from the anatomical structures of the temporal base. In conclusion, ECS was not sensitive in several patients, whereas ECoG and fMRI even showed activation within 10 mm to the resected volumes. Considering the potential signal drop-out in fMRI makes ECoG the most reliable tool to identify face selective locations in this study. A multimodal approach can improve the specificity of ECoG and fMRI, while simultaneously minimizing the number of required ECS sessions. Hence, all modalities should be considered in a clinical mapping protocol entailing combined results of co-localized face selective locations.

DOI： 10.3389/fnhum.2021.616591

PubMed

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Only several cases of internal carotid artery (ICA) stenosis involving the persistent primitive hypoglossal artery (PPHA) have been treated with carotid endarterectomy (CEA) because of its extreme rarity. CEA was performed for an 87-year-old female with severe stenosis of the right ICA–PPHA bifurcation requiring shunting from CCA to both PPHA and ICA. We initially attempted to insert two intraluminal balloon shunts into the CCA, as previously reported. However, we found this procedure technically impossible to achieve. An improvised three-way junction tube was inserted distally into PPHA and ICA and proximally into CCA, securing blood flow during CEA. Unfortunately, the patient suffered post-operative ischemic brain lesions due to the prolonged ischemic time during our initial unsuccessful shunt attempt. A three-way junction shunting tube could be an effective shunt technique during an anatomically complicated CEA.

DOI： 10.1093/jscr/rjab362

PubMed

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Isolated spontaneous common carotid artery (CCA) dissection is extremely rare. Moreover, only a few case reports for isolated spontaneous CCA dissection treated with carotid artery stenting (CAS) can be found so far. Here, the authors report a case where intravascular ultrasonography (IVUS) provided valuable information about lesion evaluation, stent selection and stent placement during CAS for isolated CCA dissection. A 69-year-old male was diagnosed with an isolated spontaneous left CCA dissection. CAS assisted with IVUS was performed to prevent further dissection and cerebral infarction recurrence. To the best of our knowledge, this is the first case report of an isolated spontaneous CCA dissection treated with CAS assisted by IVUS. CAS assisted by IVUS may be an effective treatment option to prevent intraoperative complications and further stroke recurrence for isolated spontaneous CCA dissection.

DOI： 10.1093/jscr/rjab232

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

開催年月日： 2022年3月

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：旭川  

開催年月日： 2022年3月

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：札幌  

開催年月日： 2022年3月

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：札幌  

開催年月日： 2022年3月

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：札幌  

開催年月日： 2021年12月

記述言語：英語   会議種別：ポスター発表  

開催地：有馬温泉  

受賞区分：国際学会・会議・シンポジウム等の賞  受賞国：オーストリア共和国